Seongae Park

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

26NJ00112200 Issued in NJ

Practice address

1825 Kennedy Boulevard
Jersey City, NJ 07305

Phone

(201) 547-6100

NPI assigned

May 10, 2007

Last updated

Nov 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robert Wood Johnson Physician EnterpriseGroup PAC ID 5597917633, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spark58984@epicdirect.rwjbh.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert Wood Johnson Physician Enterprise

  • Family Medicine Physician
  • Somerset, NJ
  • NPI 1245587922
  Medicare reassignment Care Compare group NPD
• MM JC Breathing Center Family LTD Partnership

  • Internal Medicine Physician
  • Jersey City, NJ
  • NPI 1235365354
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1528273075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 CARLISLE RD",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 KENNEDY BOULEVARD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07305",
            "telephone_number": "201-547-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SEONGAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00112200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyojin Park
• Isaac Park
• Jina Park, LCSW
• Jung Ho Park
• Min Park
• Soyoung Park
• Toni Park, PHARMD, RPH
• Young K Park, M.D.
• Shanell Parker
• Danielle Parkes, DC

• Acute Care Nurse Practitioner in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Acute Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.